Pharmacokinetics of Ch14.18 in Younger Patients With High-Risk Neuroblastoma
Pharmacokinetics of the Chimeric Anti-GD2 Antibody, ch14.18, in Children With High-Risk Neuroblastoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. Describe the pharmacokinetics of ch14.18 (monoclonal antibody Ch14.18) in children with high-risk neuroblastoma.
II. Quantify the degree of inter-patient and intra-patient variability in the clearance of ch14.18, and correlate ch14.18 clearance with patient characteristics, the presence of human anti-chimeric antibody (HACA), tumor burden (assessed on scans), and plasma GD2 levels to identify sources of variability in the clearance.
III. Develop a pharmacokinetic model to describe the pharmacokinetic profile of ch14.18 and derive pharmacokinetic (PK) parameters.
SECONDARY OBJECTIVES:
I. Correlate plasma concentrations of ch14.18 with the severity of neuropathic pain, which is being quantified using an observational pain scale, and the total dose of morphine administered to control pain.
II. Develop a limited sampling strategy that will accurately quantify the area under the curve (AUC) of ch14.18.
III. Simulate alternative dosing strategies with the pharmacokinetic model in order to reduce variability and simplify drug administration.
OUTLINE:
Patients undergo blood sample collection at baseline and during and after course 1, 3, or 5 of treatment for pharmacokinetic analysis. Some patients undergo blood sample collection at baseline and during and after two treatment courses (1 and 3, 1 and 5, or 3 and 5).
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Contacts and Locations
Study Locations
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Children's Hospital of Philadelphia
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Diagnosis of high-risk neuroblastoma
- Enrolled on the COG protocol ANBL0032 or ANBL0931 and eligible to receive ch14.18 according to the criteria on these primary treatment protocols
- Parental informed consent and verbal assent of the subject when appropriate
Exclusion Criteria:
- Prior testing demonstrating the presence of HACA
- Anaphylactic reaction to ch14.18 on a prior treatment cycle
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
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Ancillary-Correlative (pharmacokinetics of ch14.18)
Patients undergo blood sample collection at baseline and during and after course 1, 3, or 5 of treatment for pharmacokinetic analysis.
Some patients undergo blood sample collection at baseline and during and after two treatment courses (1 and 3, 1 and 5, or 3 and 5).
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Correlative studies
Correlative studies
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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PK parameters of monoclonal antibody ch14.18 in children with high?risk neuroblastoma during and after 4 daily 10?hour infusions
Time Frame: Before and after infusion on days 3-5; before, after, 4-6 hours after, and 12-14 hours after infusion on day 6; on the morning of days 10, 14, 17, and 24; and before infusion on day 31
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PK parameters include the peak concentration, trough concentration, AUC, clearance, volume of distribution, half-life, and mean residence time.
PK parameters will be derived from the plasma concentration-time data.
A one-compartment model fit to the concentration-time data will estimated the volume of distribution and the first order elimination rate constant, which will in turn be used to calculate clearance, half-life, AUC0-infinity, AUC0-last, and the mean residence time.
An error function and the dependency for each fitted parameter will be reported.
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Before and after infusion on days 3-5; before, after, 4-6 hours after, and 12-14 hours after infusion on day 6; on the morning of days 10, 14, 17, and 24; and before infusion on day 31
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Coefficient of variation of monoclonal antibody ch14.18 clearance
Time Frame: Up to 58 days
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The coefficient of variation of Ch14.18 clearance is used to quantify the degree of inter-patient and intra-patient variability of monoclonal antibody ch14.18 pharmacokinetics.
The relationship between patient characteristics, HACA, tumor burden, and plasma GD2 levels will be assessed graphically in an exploratory fashion with regression models.
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Up to 58 days
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Severity of neuropathic pain, quantified using an observational pain scale based on the Face, Legs, Activity, Cry, Consolability scale (FLACC) and the total dose of morphine delivered
Time Frame: Up to 58 days
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The pain measures will be correlated with plasma concentrations of monoclonal antibody ch14.18 simulated using the PK model and the monoclonal antibody ch14.18
AUC0-96 hours.
The overall drug exposure during the infusion will be correlated with the total morphine dose administered over the 4 days of treatment.
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Up to 58 days
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AUC of Ch14.18
Time Frame: Up to 58 days
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A limited sampling strategy that will accurately quantify the AUC of monoclonal antibody ch14.18 will be developed.
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Up to 58 days
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Alternative dosing strategies
Time Frame: Up to 58 days
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Alternative dosing strategies will be simulated with the pharmacokinetic model in order to reduce variability and simplify drug administration.
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Up to 58 days
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Frank M Balis, Children's Hospital of Philadelphia
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Chemically-Induced Disorders
- Nervous System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms, Glandular and Epithelial
- Neoplasms, Neuroepithelial
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neuroectodermal Tumors, Primitive
- Poisoning
- Neuroectodermal Tumors, Primitive, Peripheral
- Neurotoxicity Syndromes
- Neuroblastoma
Other Study ID Numbers
Other Study ID Numbers
- NCI-2011-02975 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- P30CA016520 (U.S. NIH Grant/Contract)
- CHP-1002
- CDR0000701215
- CHP1002 (Other Identifier: Children's Hospital of Philadelphia)
- 9122 (Other Identifier: CTEP)
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